Ideally, during natural childbirth your little one would come into the world with pushing only. But sometimes babies don’t arrive according to plan and need some assistance before they’re welcomed into your arms. When this is the case, your doctor may use either forceps or a vacuum to help your delivery. This is known as an assisted delivery.
Forceps are a metal instrument used to guide a baby’s head through the birth canal during a difficult delivery. They cradle the bones of the baby’s skull while also applying traction to help the baby pass through more easily. The appearance of the forceps can vary slightly, but they’re often compared to a pair of long and large spoons. The spoon-like ends are intended to go around the baby’s head. When a laboring mother is pushing, a doctor may use forceps timed with her contractions to help pull the baby out.
A vacuum used during delivery isn’t the same as a household vacuum. But it does involve applying suction to a baby’s head. The vacuum has a handle that allows your doctor to gently guide your baby’s head through the birth canal. The combination of the suction and traction help move the baby’s head.
Both assisted delivery methods aren’t used during a routine delivery. However, either may help if your labor isn’t progressing as your doctor would hope.
Pros for Vacuum
The use of a vacuum during delivery has become more common than forceps. A vacuum generally requires less anesthesia and pain-relieving medications than forceps.
Use of a vacuum is associated with less risk for a cesarean delivery compared to forceps. It’s also associated with less risk of maternal death and maternal trauma.
Cons for Vacuum
Vacuum extraction has higher failure rates than using forceps. When a vacuum extraction fails, a woman may need a cesarean delivery. Cesarean deliveries increase the risk for complications for the mother and the baby.
Also, vacuum-assisted delivery can increase the risk for certain complications. These complications include retinal hemorrhage in the baby. Retinal hemorrhage occurs when there is bleeding in the blood vessels of the retina. Another complication is cephalhematoma. This is a collection of blood between the skull bones and tissue of a baby’s head. These complications are associated with trauma during birth.
Pros for Forceps
The World Health Organization found that forceps are associated with greater success in achieving vaginal delivery than a vacuum. Doctors who are classically trained or who have been in practice for many years are more likely to use forceps than vacuum extraction as an approach to delivery.
Use of forceps has less risk of cephalhematoma than the use of a vacuum.
Cons for Forceps
Use of forceps is associated with greater risks for vaginal tears than vacuum extraction. A doctor can repair these tears, but they can extend recovery times.
Just as vacuum-assisted delivery can cause complications, so can forceps. Forceps deliveries are associated with greater risk for facial nerve damage. These complications are rare, but they are more common in the use of forceps. Forceps also carry a risk of retinal hemorrhage and cephalhematoma.
Technique is vital to each delivery approach. The doctor must be well-versed in vacuum or forceps delivery to ensure it’s as safe as possible. You should discuss these delivery methods with your doctor before your delivery.
If you’re making your birth plan or are trying to better understand the birthing process, ask your doctor a few questions in advance. Examples may include:
- At what point might you use a device like forceps or vacuum in delivery?
- Do you typically use forceps over vacuum or vice-versa?
- What are some of the ways we can reduce the need for forceps or vacuum?
- What are some of the risks to me and my baby with either delivery approach?
Your doctor won’t really know if you need assistance with forceps or vacuum until the active stage of labor, or when you’re pushing. Discussing each option beforehand can help you understand why your doctor may recommend using vacuum or forceps.